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<br />Monitoring Well Sampling Form <br />Ib No, '~3~-qc~.S SIU Nama (~QSTI ~ l~} /~ ~-OpV-~`~ <br />mplara Q , (~A ~p(J qEQ DNa // ~~ ~S ' Rsvlswad by <br />R ~ <br /> <br />DaU <br />Shat of <br /> Welol 111 Woll(11 <br />iompling <br />Older <br />Wsll Dlem. <br />In. <br />Dets <br />Tlme Total <br />Depth Weler• <br />Level <br />Feel <br />Oellone Evse.(2) <br />Method Gdlone <br />Removed 9empllnp <br />Malfiod(~) Equlp.(~ <br />Clean.p) <br />Comments <br />I+w . ,. /l ~ D: S,S. ~/1• i3•3 •31 f~U~ ~Da pdc- ~ <br />w /z - 8 i :so 35 .6 / . •~l Puy- Z, DvL ~ <br />~ w ~' I i o4: (s D .o <br />~n w 3 y" l~ oq: o .so•bo g <br />w N I !g o9:~ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />• from WATER LEVEL AND PRODUCT THICKNESS FORM <br />TD~WL ~ FEET OF WATER 1N WELL <br />GALLONS PER FOOT OF WATER <br />2` ~ 0.2 6. 0 1.S 10' ~ ~.1 <br />~• = 0.7 B' . 2.8 12' ~ 5.9 2: WELL EVACUATION METHOD <br />P: PUMP WRH OROPLINE i0 WATER SURFACE <br />8: BUBMERSIBLE PUMP <br />B: BAILED 3: SAMPLING METHOD <br />PVC • PVC BAILER <br />PE • POLYETHYLENE DISPOSABLE BALER <br />TB • TEFLON BAILER 6K3NATURE DATE <br /> O: OTHER PD • PUMP DISCHARGE <br />S8 -STAINLESS STEEL BAILER <br />~: EQUIPMENT CLEANING: ALL EQUIPMENT (I.a. WELL PROBE, OROPLINE FOR PUMP, BALER, ETC.( WHICH WILL COME INTO CONTACT <br />WITH OTHER WELLS MUST BE CLEANED BETWEEN USES. <br /> <br />